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  • Barbara Hoefener NP

Mixing Alcohol and Suboxone

Updated: Aug 27, 2021

Barbara Hoefener, Digital Clinicians. Directly from American Addiction Centers on 8/24/21.

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Mixing Alcohol and Suboxone..

Suboxone is primarily designed to be an opioid replacement drug to assist individuals who have opiate use disorders in going through the withdrawal process with minimal discomfort. Because Suboxone is an opiate drug, it can also be used to control pain. The buprenorphine in Suboxone controls opiate withdrawal symptoms, and it can be effective in controlling mild to moderate pain. The naloxone is designed as a safeguard to keep individuals from abusing Suboxone.

Alcohol abuse is the most common form of drug abuse in the US, according to SAMHSA. Both alcohol and Suboxone (the buprenorphine component) act as central nervous system depressants, meaning that their general action results in a decrease in the rate of firing of neurons in the central nervous system (the brain and spinal cord). Mixing alcohol with any opiate drug, including Suboxone, can be an extremely dangerous and even lethal practice.

Mixing Alcohol and Suboxone

The warning labels on opiate drugs strongly advise patients who take these drugs not to take them with alcohol. Physicians are required to instruct patients to not use these drugs in conjunction with alcohol. Even though buprenorphine is a partial opioid agonist, the same precautions and effects that are associated with other opiate drugs apply to buprenorphine. Because alcohol and buprenorphine are central nervous system depressants, taking them in combination leads to an enhancement of their effects.

Side effects that might occur with buprenorphine use can be significantly increased in intensity and number when the drug is used in combination with alcohol. These side effects include:

  • Issues with nausea, vomiting, and constipation

  • Headache, blurred vision, dizziness, and fainting spells

  • Increased sweating, heart palpitations, increased or decreased blood pressure, and an increased potential for myocardial infarction

  • Decreased motor coordination, poor response times, and extremely impaired thinking processes, including issues with judgment

Because central nervous system depressants like alcohol and buprenorphine decrease the activity of the neurons in the brain and spinal cord, these drugs can contribute to a number of potentially serious conditions when used in combination on a long-term basis. These conditions include:

  • Serious effects associated with the respiratory suppression (decreased breathing rate) that both drugs induce: These effects can include respiratory infections and tissue and organ damage as a result of hypoxia (decreased blood flow to the organs and tissues). Serious brain damage can occur as a result of chronic issues with respiratory suppression.

  • Decreased blood flow as a result of heart rate alterations: Issues with decreased blood flow can, of course, produce tissue and organ damage over the long-term due to a lack of nutrients and oxygen being delivered to organs and other tissues.

  • Altered thinking processes: These can lead to an increased potential to become involved in accidents, engage in risky behaviors, or engage in intentional self-harm as a result of becoming depressed.

  • Comatose states: These occur due to a suppression of the neurons in the brain stem that control the automatic functions of breathing and heart rate. This situation can be potentially fatal or result in serious damage to the brain and other organs in the body.

Chronic use of alcohol and Suboxone in combination can also lead to a number of other potential issues that can include:

  • Increased risk for a number of different forms of cancer, including cancer of the liver, kidneys, and/or gastrointestinal system

  • Increased risk for cirrhosis of the liver, ulcers, and/or brain damage due to stroke

  • Increased risk for cardiovascular disease

  • Increased risk to contract a number of diseases as a result of a weakened immune system or as a result of engaging in unhealthy or risk-taking behaviors

  • The development of physical dependence on one or both drugs

  • The development of a substance use disorder to one or both drugs

Other Important Things to Consider

If all of the potential risks and dangers listed above are not enough to persuade an individual not to drink alcohol and use Suboxone in combination, there are some other important considerations.

  • Individuals who have a history of any form of substance abuse have often abused or misused alcohol in conjunction with other drugs. Someone attempting to recover from an opiate use disorder by using Suboxone may trigger strong cravings for opioids if they begin drinking.

  • Individuals using Suboxone to help them recover from an opiate use disorder are still in a very delicate situation. A phenomenon known as the abstinence violation effect sometimes occurs in individuals who are attempting to abstain from using drugs, overeating, drinking alcohol, etc., and have a small lapse or slip. This small lapse or slip results in the individual adopting a cavalier attitude regarding drugs or alcohol, and the individual binges excessively; they have made the determination that since they have slipped, they might as well “go all the way.” This behavior is often seen in individuals who have lapses in recovery and even in individuals who are on strict diets and suddenly have a small “treat” that leads to a short period of bingeing. Bingeing on alcohol and opiate drugs can result in a potentially fatal overdose.

  • Drinking alcohol while on Suboxone, even small amounts, can result in a number of issues with judgment that can lead to deleterious effects.

  • Drinking small amounts of alcohol while using Suboxone may result in extreme lethargy, sleepiness, and even unconsciousness that can have potentially dangerous effects.



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